免疫检查点抑制剂帕博利珠单抗诱发银屑病一例并文献复习

报道1例57岁男性肺癌患者应用帕博利珠单抗后诱发银屑病并复习相关文献。临床表现为斑块型银屑病合并掌跖脓疱病和严重甲受累，既往无银屑病史或家族史。组织病理符合银屑病。经阿维A联合窄谱UVB治疗后病情控制。回顾文献，共有25例免疫检查点抑制剂诱发银屑病的报道。大多数患者为老年男性，以肺癌和黑素瘤为主，最常报道的诱发药物为纳武利尤单抗和帕博利珠单抗，从首次用药到出现皮损的中位时间为9周，临床表现以斑块型银屑病为主，组织病理特点与经典银屑病类似，所有患者经外用药、光疗和/或系统治疗后皮损改善，大部分患者无需停用免疫检查点抑制剂。

Psoriasis induced by immune checkpoint inhibitor pembrolizumab:a case report and literature review

A 57-year-old male presented with psoriasiform eruption,palmoplantar pustulosis and severe nail involvement during treatment with pembrolizumab for lung cancer.He had no personal or family history of psoriasis.The histopathological findings were in accordance with psoriasis.The psoriatic lesions subsided after treatment with acitretin combined with NB-UVB.A total of 25 cases of psoriasis induced by immune checkpoint inhibitors(ICIs)have been reported.The majority of the patients were elderly men with lung cancer or melanoma,and the most frequently reported ICIs were nivolumab and pembrolizumab.The median delay between introduction of ICIs and psoriasis occurrence was 9 weeks.The clinical type was mainly plaque psoriasis and the histopathological manifestations were in accordance with classic psoriasis.The lesions were improved in all patients after topical medications,phototherapy,and/or systemic treatments,and ICIs were continued in most cases.